Journal Article > ResearchFull Text
Bull Soc Pathol Exot. 1 July 1999
Legros D, Fournier C, Gastellu-Etchegorry M, Maiso F, Szumilin E
Bull Soc Pathol Exot. 1 July 1999
The failure rate of melarsoprol after treatment of late stage cases of Human African Trypanosomiasis (HAT) is usually under 7%, even though the drug has been used for such treatment over the past 50 years. We report a melarsoprol treatment failure rate of 26.9% among 428 patients treated in Northern Uganda. Whatever its origin, this observation, the first documented in a HAT focus, is alarming, particularly since no second line trypanocidal drug is actually available for the treatment of late stage HAT. We believe that the current worrisome situation of HAT in several African countries and the risk of emergence of other foci of resistance, argue in favour of a greater attention on the part of the scientific community and the pharmaceutical companies being paid to this problem.
Journal Article > ReviewFull Text
Bull Soc Pathol Exot. 1 January 2000; Volume 93; 321-324.
Dorlencourt F, Priem V, Legros D
Bull Soc Pathol Exot. 1 January 2000; Volume 93; 321-324.
The International Dietary Energy Consultative Group, sponsored by the World Health Organization (WHO), has done most of the research conducted in the field of adult malnutrition in the late 1980's. These studies were carried out mainly in populations suffering from chronic malnutrition, and led to the current WHO recommendations for the diagnosis and classification of adult malnutrition. Body Mass Index (BMI) is the gold standard to be used in adults, with the following cut-off points identified: 16.0, 17.0 and 18.5. The good correlation observed between BMI and Middle Upper Arm Circumference (MUAC) led to the determination of corresponding cut-off points. However, the very few field studies available in the literature are in favor of a lowering of the BMI cut-off points during nutritional emergencies. Several questions need to be answered through field research, mainly concerning the type of indicator best predicting the risk of death, and the type of indicator to be used in adolescents, pregnant women and older people.
Journal Article > ResearchFull Text
Bull Soc Pathol Exot. 1 February 2009
d'Alessandro E
Bull Soc Pathol Exot. 1 February 2009
In this article, we propose a history of Médecins Sans Frontières's control activities to fight human african trypanosomiasis. Through this history are enlightening medical innovations in the scope of diagnostic and treatment of the disease. MSF investing will focus successively on (1) epidemiological and clinical diagnosis, (2) existing drugs evaluation and (3) development of new therapeutic protocols. After a period of isolation, MSF will have to cooperate with others international health organizations. Specific questions on medical practice and research in the south countries will represent the major issues regarding medical innovation.
Journal Article > ResearchFull Text
Bull Soc Pathol Exot. 1 December 2002; Volume 95 (Issue 5); 351-354.
Brown V, Jacquier G, Bachy C, Bitar D, Legros D
Bull Soc Pathol Exot. 1 December 2002; Volume 95 (Issue 5); 351-354.
Cholera epidemics in refugee camps represent a major public health emergency. In camps, precarious living conditions contribute to the transmission of the vibrio. Among the major epidemics reported in camps, we note as well those which have affected Africa in the last two decades. These epidemics are characterized by high attack rates and high case fatality ratios. Attack rates in refugee camps can exceed 5%. Appropriate control measures are adopted at international level. Actions carried out urgently must allow the proper supply of water, the control of excreta, and the improvement of general sanitary conditions and individual hygiene. Efficient management of cases in specialized cholera treatment centres (CTC) should decrease the case fatality ratio to less than 1%. Treatment is mainly based on the prompt rehydration of patients. For wide camps, rapid access to oral rehydration units is essential. Availability of all necessary equipment in kit form is required.